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Invited Commentary
January 4, 2017

Care of the Injured PatientDetermining Who Needs Transfer

Author Affiliations
  • 1Division of Acute Care Surgery, Emergency General Surgery, The Johns Hopkins University, Baltimore, Maryland
JAMA Surg. Published online January 4, 2017. doi:10.1001/jamasurg.2016.5002

The delivery of care to the injured patient through organized trauma systems has been clearly shown to improve outcomes. In 2006, MacKenzie et al1 demonstrated the importance of trauma-center care on mortality compared with patients taken to nontrauma centers. Since the formation of the American College of Surgeons Committee on Trauma (ACS-COT), there has been a robust and continuous effort to improve care to the injured patient. With the variability in resources and capabilities across this country, clinicians must determine which patients should be transferred to facilities that provide a higher level of care. As part of the decision-making process, the ACS-COT has developed guidelines2 for the transfer of trauma patients between institutions. These guidelines are considered an essential part of a trauma system.

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